Post-surgical hemorrhagic infarction of the adrenal gland as the first clinical manifestation of antiphospholipid syndrome after 43 years of antibody-positivity

Abstract

We report on a male patient who tested positive for antiphospholipid antibodies for 43 years without thromboembolic manifestation of antiphospholipid syndrome (APS). He has been followed up in a prospective cohort study since 2001. Following his second hip replacement surgery, the patient developed acute adrenal failure due to bilateral hemorrhagic infarction. Prophylactic anticoagulation, surgery, or an immunological reaction to blood transfusion may have triggered this late and unusually located primary manifestation of APS in our patient.

Keywords::

• Antiphospholipid syndrome
• APS
• Antiphospholipid antibodies
• Acute adrenal failure

Acknowledgments

We would like to express our great appreciation to Professor Klaus Lechner for sharing his constructive ideas and valuable advice, and to Tanja Altreiter for proofreading the manuscript.

Conflict of interest

None.